We applaud the work of Warthan and colleagues.1 Their effort to apply an addiction model to sunbathing behavior illustrates the benefits of an integrated approach to dermatology that seeks to find links between the psyche and the soma. However, we wonder if other models that look at psychological conflict and the impact of body image, development, and self-esteem would also be useful in helping us to understand those who continue to act in self-destructive ways.